Kelly Jean Tibbetts, LICSW - Clinical Social Worker in Spring Park, MN

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Kelly Jean Tibbetts, LICSW is a Social Worker - Clinical based in Spring Park, Minnesota. Kelly Jean Tibbetts is licensed to practice in Minnesota (license number 22636) and her current practice location is 4154 Shoreline Dr Ste 202, Spring Park, Minnesota. She can be reached at her office (for appointments etc.) via phone at (952) 491-9450.

NPI number for Kelly Jean Tibbetts is 1992350367 and her current mailing address is Po Box 13, Wrenshall, Minnesota. She does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1992350367.

Contact Information

Kelly Jean Tibbetts, LICSW
4154 Shoreline Dr Ste 202,
Spring Park, MN 55384-5610
(952) 491-9450
Not Available

Map and Direction




Healthcare Provider's Profile

Full NameKelly Jean Tibbetts
GenderFemale
SpecialitySocial Worker - Clinical
Location4154 Shoreline Dr Ste 202, Spring Park, Minnesota
Accepts Medicare AssignmentsDoes not participate in Medicare Program. She may not accept medicare assignment.
  NPI Data:
  • NPI Number: 1992350367
  • Provider Enumeration Date: 08/02/2019
  • Last Update Date: 06/06/2025

Medical Identifiers

Medical identifiers for Kelly Jean Tibbetts such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1992350367NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
1041C0700XSocial Worker - Clinical 22636 (Minnesota)Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Kelly Jean Tibbetts is NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Kelly Jean Tibbetts, LICSW
Po Box 13,
Wrenshall, MN 55797-0013

Ph: (218) 409-7508		Kelly Jean Tibbetts, LICSW
4154 Shoreline Dr Ste 202,
Spring Park, MN 55384-5610

Ph: (952) 491-9450

Reviews and Comments


Social Worker in Spring Park, MN

Jennie Jean Pogreba, LICSW
Clinical Social Worker
Medicare: Not Enrolled in Medicare
Practice Location: 4154 Shoreline Dr, Spring Park, MN 55384
Phone: 612-567-0316    Fax: 952-491-9460

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.